Telemedicine: The top 3 obstacles facing clinicians today

Effective telemedicine solutions must be reliable, secure and deliver a user-friendly experience.

Shortages of healthcare specialists in rural areas combined with advances in video communications technology are driving telemedicine services to new heights, according to a report last year from Research and Markets. The analyst group predicts the global telemedicine market will grow from $14.2 billion in 2012 to more than $39 billion in 2018. As more and more health delivery systems turn to telemedicine strategies, they are discovering that it is not that simple to set up and manage. Many pilot efforts have failed due to poorly designed network connectivity, complicated clinical workflows, confusing technology user experiences, unreliable equipment and lack of ROI in terms of clinical outcomes or financial benefits. More than a few telemedicine carts are sitting in storage closets because they failed to work at the right time and medical staff moved on to other alternatives.

Health delivery systems could benefit from partnering with one of several experienced video communications management and service companies who have helped run Video Network Operation Centers for complex video deployments at large global enterprises and federal government agencies. Best practices gained from years of experience in other sectors could shorten the learning curve and launch more effective and successful telemedicine networks in healthcare today.

Following are three obstacles that typically result in a failed telemedicine implementation along with an explanation of how a reputable VNOC service provider can be the differentiator in overcoming these challenges.

Challenge #1: Complex telemedicine equipment. One of the primary goals of telemedicine is quicker and better access to patient care. When patients and clinicians spend several minutes trying to figure out how to turn on equipment, set up a conference session and use the system's features, the technology becomes the focus of the encounter rather than the patient. An experienced telemedicine VNOC provider can help healthcare practices avoid this scenario in a couple of ways:

User interface and user experience. The VNOC provider can provide consultation in the design and implementation of a telemedicine network, optimizing uptime, connectivity and seamless, user-friendly interfaces. Best practices can be deployed from other healthcare clients or from other industries that are applicable to clinical healthcare environments. Telemedicine endpoints and medical peripheral device integration can be greatly streamlined and simplified to facilitate a smoother clinical workflow.

Training. Sometimes the issue is a familiarity problem. Although a healthcare practice may have general IT support, a detailed, comprehensive understanding of the telemedicine network and devices and what might go wrong is usually lacking, leaving the clinician with little or no help. Lack of good end-user training is a common problem with unsuccessful deployments. A full-service VNOC provider can deliver complete onsite end user training prior to and during an implementation. And once up and running, the VNOC provider can offer live training refreshers via a dedicated support number.

Challenge #2:System downtime. Unfortunately there are a multitude of pieces that must fall into place for a telemedicine deployment to work. The network, the firewall, the bandwidth, the signal strength, the connectivity, the hardware and software components and the medical devices all need to work — and work together. When a telemedicine cart goes down, it is hard to know where to start troubleshooting the problem. Lack of reliable equipment and connectivity are probably the greatest impediments to successful telemedicine deployments. If the cart is down, the clinical staff stops using telemedicine and is reluctant to try it again. A VNOC provider can avoid this problem by managing the entire system, including:

Proactive monitoring and 24/7 real-time support. A good VNOC can proactively monitor a telemedicine network, providing diagnostic analysis at regular intervals catching problems and resolving them before a telemedicine encounter even starts.

Instant triage support. If a problem occurs during a patient encounter, the VNOC can rapidly triage the situation with a complete view and understanding of all the various components of the telemedicine network and equipment. Most problems can be solved remotely by a full-service VNOC provider's helpdesk, and within minutes the telemedicine encounter and clinical workflow can be reestablished.

Peace of mind. When the situation involves a failed component, a good VNOC provider has comprehensive service-level agreements in place to fix or replace the failed component within minutes in emergency situations or the next calendar day in non-emergency situations.

Anything short of this level of management from a VNOC will likely mean that a telemedicine network is experiencing too much downtime to be successful over the long haul.

Challenge #3: Security and privacy. Many healthcare practices choose to implement telemedicine solutions without outside help because they believe they need to keep tight control over the system for security and HIPAA compliance concerns. Unfortunately due to the complexity of video conferencing networks, firewall traversals, encryption and authentication protocols, systems can be deployed improperly, resulting in significant security and privacy breaches.

Partnering with a VNOC provider that has experience with video conferencing deployments in highly secure environments (e.g., U.S. Department of Defense, NASA, Social Security or banking) can actually result in greater security and privacy controls being implemented than can be achieved in-house. The right VNOC provider can improve security and privacy in three ways:

Video communication security and privacy. Ensuring the telemedicine network is secure and conference sessions are encrypted without compromising the real-time flow of voice and video packets is no easy matter. IT personnel not trained in unified communications can easily make mistakes that lead to a compromise in security (e.g., a data port is left open or an authentication step is left out) or performance (e.g., calls have drop outs, echo, jitter, etc.). The right VNOC managed services provider, on the other hand, has industry-wide experience in configuring a video conferencing deployment in a way that optimizes security without compromising performance.

ISO 27001:2013 Information Security Accreditation. A VNOC service provider that is ISO 27001:2013 certified has implemented an Information Security Management System that follows the highest standards and best practices of security protection and safeguards. Such an accreditation ensures that any design, implementation and management of a telemedicine network done by the VNOC partner will follow those security standards and best practices.

Compliance and accountability. As a trusted business advisor, the right VNOC partner will assure healthcare practices that it holds its employees to the highest protected health information standards by having in place a legally binding HIPAA privacy agreement between the VNOC partner and the healthcare practice. As a result, the healthcare practice can hold the VNOC partner to the same privacy accountability as they do for their own employees.

Creating a positive transformation in healthcare Frost & Sullivan's Connected Health Global Research Director Daniel Ruppar has said, "Video telemedicine is one of the top areas in telehealth that can enable a positive transformation in healthcare delivery."

With any new service, there are new challenges and obstacles that must be overcome before the service can make the transition from novelty to necessity. In addition to investing in business-grade technology and bandwidth, choosing the right VNOC service provider will go a long way in ensuring success in providing this game-changing service.

Peter McLain has more than 15 years experience in healthcare IT, and recently joined Yorktel, a global communications and video services provider with more than $100 million in annual revenue after an extended tenure with Rubbermaid Healthcare where he served as national sales manager for telemedicine, as well as telemedicine development manager. Before landing at Rubbermaid, he was vice president of business development for CPort Solutions, preceded by 10 years in executive sales management representing medical devices and software solutions from Johnson & Johnson, DePuy, Zimmer and other manufacturers.